Daniel Hagerman, recovering heroin addict who has been sober for seven and a half months.

Pierce County health officials say opioid substance abuse is an epidemic, yet the clinics that administer outpatient methadone treatment for addicts are few. There are only two countywide — one in Tacoma and another in Lakewood.

That’s partly because clinics offering methadone maintenance are some of the most highly regulated facilities around.

Now, Puyallup could be the county’s third destination for outpatient methadone treatment, as Northwest Integrated Health seeks to start a certified program.

2 Number of methadone treatment programs currently located in Pierce County. One is operated in Tacoma by the Tacoma-Pierce County Health Department. The other is a private facility in Lakewood.

Methadone maintenance uses a synthetic substance as a substitute for highly addictive opioids, such as heroin. Methadone is administered over a prolonged period of time. Some patients need treatment indefinitely when detoxification efforts fail.

Dr. Asif Khan, CEO of Northwest Integrated Health, said his clinic is an ideal location to combat the opioid abuse that he says is rampant in East Pierce County. He said methadone treatment is meant to help addicts function well enough to become productive members of society.

“It’s not just to get high,” Khan said, stressing his proposed methadone program is aimed at treating negative symptoms from withdrawal.

The Puyallup City Council wants more time to learn about methadone before giving Khan approval. On Nov. 10, the council unanimously approved a 90-day ban on methadone clinics within city limits.

A public hearing is scheduled for Tuesday night at Puyallup City Hall.

City Attorney Steve Kirkelie said the decision wasn’t “anti-methadone.”

“We’ve never had this type of use in the city before,” Kirkelie said. “We need to look at what impacts we can expect from this and how to mitigate the impacts.”

Northwest Integrated Health is located behind a strip mall that includes businesses such as T.J. Maxx and Office Depot. It’s a short drive from the South Hill Mall, Bradley Lake Park and the Mel Korum YMCA.

“It’s a very busy part of the city,” Kirkelie said.

He said the city is also anticipating long-term plans for the Willows Pond property across the street, which may be the future home of a public trail and a senior living center.

Methadone treatment has been controversial in some places. Opponents argue that it replaces one addiction with another. Proposals to open clinics in some U.S. communities have faced criticism from neighbors who fear the facilities will invite more addicts and subsequent increases in problems such as crime and drug use.

IMPROVING TREATMENT

Khan’s clinic moved to 3800 3rd Street SE in March, relocating from another office on 23rd Avenue Southeast and South Meridian, where it had treated patients since 2010.

Two full-time and four part-time physicians, as well as five counselors, treat roughly 250 patients, Khan said.

He said the goal with the proposed methadone program is to build on what’s already offered to patients like Hagerman. That includes giving patients the tools to improve their lifestyle, treating opioid addiction like any other chronic disease.

In the 10 years he’s practiced in Puyallup — six of them dedicated to substance-abuse treatment — Khan said he realized that limits on opioid alternatives kept him from administering the best care possible to as many people as possible.

Allowing access to methadone, he said, would not only improve access to medication, but also increase the number of patients the clinic could legally treat.

“There’s a huge need in the area. Saying ‘no’ to all those patients every day — it’s not easy,” Khan said. “Their lives are at stake.”

There’s a huge need in the area. Saying ‘no’ to all those patients every day — it’s not easy. Their lives are at stake.

Methadone may be administered only as part of certified opioid treatment programs, which are highly regulated at all levels of government.

Khan estimates his clinic’s proposed program wouldn’t begin for at least eight months, perhaps a year.

He’s working on an extensive checklist to launch the program: community outreach, health department licensing, public hearings, Drug Enforcement Administration vetting and accreditation, among other requirements.

The program also would be subject to a probationary period and an audit every three years.

Khan said clinics that offer methadone are the most highly regulated medical facilities.

“That’s why there are none in East Pierce County,” he said.

He said his clinic, located in what he considers a hidden spot, hasn’t done any marketing or outreach.

Still, it handles about 30 calls a week from addicts hoping to become patients. Most are turned away, Khan said, because the clinic currently can’t treat all of them.

However, if a methadone-facility license is granted to the clinic, Khan said it will be eligible to serve many more patients.

The state allows methadone programs to treat up to 350 patients. But Pierce County allows clinics to treat up to 500, so long as the county and local city council authorize the increase, said Christina Abby, program manager for the health department’s treatment services program.

UNFAMILIAR TERRITORY

Kirkelie, the city attorney, said the goal during Puyallup’s temporary ban on methadone clinics is to reach out to cities that allow them and determine what should — and shouldn’t — concern local officials.

He stressed that Puyallup wants to balance viable treatment options with public safety.

“This is not an anti-methadone proposal,” he said of the city’s moratorium. “It’s just us trying to do our due diligence and make sure we look at all the different angles.”

We’ve never had this type of use in the city before. We need to look at what impacts we can expect from this and how to mitigate the impacts.

Councilwoman Julie Door agreed, adding that the move to temporarily ban the clinics isn’t meant to deny treatment, but rather to carefully review city code.

“This is a reasonable step to take,” Door said.

Mayor John Knutsen told The News Tribune last week that his main concern is where methadone clinics would be allowed to operate. He said he doesn’t want to see them downtown, for example.

Khan acknowledged the city’s concerns, but stressed his clinic is behind a building surrounded by open space and parking lots. A security guard will patrol regularly, he added.

Additionally, all patients would be required to leave the premises upon receiving methadone treatment. Khan said anyone who loiters in violation of that policy would lose patient privileges.

Khan said his priority is to maximize the number of patients he can effectively treat, not to push methadone on them.

“Not every patient will be treated with methadone,” he said.

METHADONE ‘SAVES LIVES’

Abby, the health department’s program manager, said offering outpatient methadone treatment in Puyallup would improve public safety and prevent the spread of disease.

“It saves money, saves communities, saves lives,” she said.

In the communities where the clinics exist, Abby noted, national data show positive effects. She said every $100,000 invested in a methadone clinic saves $700,000 in law enforcement spending.

Data also consistently show decreases in prostitution, theft and other crimes — the offenses that addicts commit when they’re desperate and treatment isn’t available, Abby added.

Equally important, Abby said, is the prevention of the spread of infectious diseases through education. She said methadone patients are more likely to have HIV and hepatitis C.

Hagerman, sitting in a bare room Thursday, updating Khan on his progress, said he’s sad to see his time with his support group come to an end soon. What started out as a requirement to receive his medication turned into a big part of his life.

Although he doesn’t use methadone or plan to, he said well-regulated, expanded addiction services would be positive.

“It’s good to know this place is here for people when they’re ready,” Hagerman said. “It’s a good thing for people who want to get their lives together.”